Improvements in illness self-management and psychological distress associated with telemonitoring support for adults with diabetes.
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Date
2015-03-11
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Abstract
OBJECTIVE The objective of this observational open label trial was to characterize changes in diabetes self management and psychological distress associated with a mobile health mHealth interactive voice response IVR self management support program METHODS For 3 6 months 301 patients with diabetes received weekly IVR calls assessing health status and self care and providing tailored pre recorded self management support messages Patients could participate together with an informal caregiver who received suggestions on self management support and patients clinicians were notified automatically when patients reported significant problems RESULTS Patients completed 84 of weekly calls providing 5682 patient weeks of data Thirty nine percent participated with an informal caregiver Outcome analyses adjusted for study design factors and sociodemographics indicated significant pre post improvement in medication adherence physical functioning depressive symptoms and diabetes related distress all p values Under0 001 Analyses of self management problems indicated that as the intervention proceeded there were significant improvements in patients IVR reported frequency of weekly medication adherence SMBG performance checking feet and frequency of abnormal self monitored blood glucose readings all p values Under0 001 CONCLUSIONS We conclude that the combined program of automated telemonitoring clinician notification and informal caregiver involvement was associated with consistent improvements in medication adherence diabetes self management behaviors physical functioning and psychological distress A randomized controlled trial is needed to verify these encouraging findings